体位和操作方法对重度磨耗患者正中关系记录的影响

Effects of body posture and manipulation on the recording of centric relation of the patient with severe dentalattrition

目的:记录6例口颌系统功能基本正常而需要建的中老年重度磨耗患者的正中关系,评价体位和操作方法对正中关系记录的影响。方法:铰链轴法确定髁突运动轴点,关系采用三维电子式髁突运动描记仪Pantronic记录并转移至Denar D5A型全调节式咬合架上,对6例需要建的重度磨耗患者正中关系,在不同体位下髁位的可重复性变化进行评价。结果:操作方法对正中关系的记录有一定影响。在前后方向,用双手扶持法BMP所获得的正中关系改变很小,且以仰卧位的变化最小;而颏点诱导法LCPG在2种体位下的位移量大,接近0.8mm。在上下方向,LCPG的位移量稍大于BMP,接近0.3mm。比较LCPG和BMP,在仰卧位,在前后方向上,LCPG和BMP之间存在0.65mm的均差,在上下方向存在0.17mm的均差,有明显的统计学差异(p<0.05)。在直立位,在前后方向,LCPG和BMP之间存在0.41mm的均差,但在上下方向的均差非常小(p>0.05)。结论:操作方法及体位对正中关系的记录有一定影响,临床若考虑采用BMP记录颌位,最好选用仰卧位进行记录,若考虑采用LCPG记录颌位,建议选用直立位进行记录,以提高记录结果的准确性。

Objective: Evaluation to the effects of body posture and manipulation on the recording of centric relationof 6 patients with severe dental attrition in healthy stomatological system for clinical application. Methods: Using D5ADenar fully adjustable articulator and the Pantronic recording system, we investigated reproducibility of the centric relationof 6 patients with severe occlusal attrition. Results: Manipulation and posture would affect reproducibility of the CR.Change of bilateral manipulation (BMP) was smaller in anteriorposterior direction, particularly in supine position. Changeof the light chin guidance (LCPG) was close to 0.8mm,which was higher than that of the BMP between upright and supineposition, but not significant statistically. In superiorinferior direction, displacement of the LCPG was slightly higher thanthat of the BMP, the value is near to 0.3mm. Comparing the LCPG with the BMP, 0.65mm paired mean difference waspresent between the LCPG and the BMP in supine position anteriorposteriorly, whereas 0.17mm paired mean differencesuperiorinferiorly; the difference is significant (p<0.05). In the upright position, 0.41mm mean difference was presentbetween the LCPG and the BMP in AP direction, but variation in the SI direction was small p>0.05).Conclusions:Manipulation and posture affected reproducibility of the centric relation. Change of the centric relation with the BMP issmaller particularly in supine position. Change of the centric relation with the LCPG was higher than that of the bilateralmanipulation between upright and supine position, but mainly significant in anteriorposterior direction.